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Q. I've had a stiff neck off and on for 10 years. The...

December 28, 1998|By Dr. Allen J. Douma.

Q. I've had a stiff neck off and on for 10 years. The stiffness and pain goes down into my shoulder blade and sometimes doesn't go away for days. When I go to sleep at night, should I lie so that it hurts or doesn't hurt? I'm thinking that if I lie in a certain way, I can counteract the pain and be OK in the morning.

A. Lying so that your stiff neck is stretched may be interesting in theory, but unless you want to cause another problem, namely insomnia, I don't suggest you try this home remedy. Almost everyone has had a stiff neck. For many, gentle stretching of the muscles coupled with cold and heat is effective in relaxing neck muscles. A gentle massage, especially by a trained person, can have wonderful results.

As with any medical symptom, an important first step is to determine the cause of the symptom. Neck pain and stiffness is a chicken-and-egg situation. By that, I mean that neck stiffness can cause pain but, likewise, neck pain can cause stiffness.

Some causes of either or both include meningitis, spinal cord problems, injury or disease of vertebrae in the neck (cervical vertebrae), and tension headaches.

Because meningitis is a medical emergency, it's important to recognize the symptoms. These may include the sudden onset of headache, fever, neck and upper-back pain, and abnormalities in hearing and vision.

Stiff neck also is often caused by straining or overuse of the neck muscles. Muscle strain in turn can be caused by a sudden jerking of the head, such as occurs in sudden deceleration injuries during car accidents or sports injuries.

But it also can be caused by chronic overuse of the neck muscles by improper posture over extended periods, for example, while working at a computer terminal or even watching television.

One of the more common causes of neck stiffness is sleeping with the head in an unnatural position. This can occur to people who fall asleep on a chair or sofa while watching television.

Once neck stiffness and pain due to overuse begins, the person will naturally avoid the actions that started it. But unless the actions are curtailed, the pain will tend to recur over and over, each time with less provocation needed.

At the first sign of neck pain due to overuse, applying a cold pack for a few hours may help. After that, warm packs with gentle massage and gentle stretching are also helpful.

Over-the-counter pain medications are effective in treating the pain and may help by decreasing the minimal inflammation that also exists.

As you probably know, too much pain medication can be harmful to your stomach, and it may be harmful for your neck. Your body sends out pain signals to remind you not to use your neck. If the pain is removed completely, you are more likely to reinjure it.

I don't think you should purposely sleep in a position that stretches your neck and causes pain. Even if this stretching were helpful at first, there is too much danger that it will hurt after you fall asleep.

It is important to sleep with your head and neck in a neutral position that relieves as much strain from the muscles as possible. This will require experimentation with the kind of head support you use and with the position of your body.

This experimentation will be especially worthwhile because improper positioning during sleep may be the cause of your neck pain and stiffness in the first place.